Provider Demographics
NPI:1215190426
Name:NEWBORN CLINICS OF AMERICA LLC
Entity Type:Organization
Organization Name:NEWBORN CLINICS OF AMERICA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NNP BC
Authorized Official - Prefix:
Authorized Official - First Name:KATHRYN
Authorized Official - Middle Name:
Authorized Official - Last Name:MCKNIGHT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:678-398-0478
Mailing Address - Street 1:1790 MULKEY ROAD BLDG. 10 SU. 10
Mailing Address - Street 2:
Mailing Address - City:AUSTELL
Mailing Address - State:GA
Mailing Address - Zip Code:30106
Mailing Address - Country:US
Mailing Address - Phone:678-398-0478
Mailing Address - Fax:770-941-3186
Practice Address - Street 1:1790 MULKEY ROAD BLDG. 10 SU. 10
Practice Address - Street 2:
Practice Address - City:AUSTELL
Practice Address - State:GA
Practice Address - Zip Code:30106
Practice Address - Country:US
Practice Address - Phone:678-398-0478
Practice Address - Fax:770-941-3186
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-08
Last Update Date:2010-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center